Endothelial Function in Children with Acute Lymphoblastic Leukemia (ALL) May Reflect the Clinical Outcome.

Adrian Doroszko,Aleksandra Turek-Jakubowska,Julita Porwolik,Ewa Niedzielska,Maciej Jakubowski,Arkadiusz Derkacz,Bartosz Sieczkowski,Aneta Radziwon,Alicja Chybicka,Piotr Dobrowolski,Ewa Szahidewicz-Krupska,Grzegorz Mazur,Robert Skomro,Andrzej Szuba

doi:10.1155/2018/7918091

Abstract

Endothelial dysfunction is a common feature of early complications of hemato-oncologic therapy. The aim of our study was to assess the profile of endothelial function at diagnosis time, then during initial treatment phase of acute lymphoblastic leukemia (ALL), and to verify the presence of its correlation with early clinical outcome (ECO). 28 ALL children and 18 healthy age-matched control ones were recruited. Study group was examined at baseline and at 33rd and 78th day of treatment. At each protocol step the endothelial function was assessed by measurement of sP-selectin (CD62-P), PAI-1(serpinE1), sE-selectin (CD62E), sICAM-1(sCD54), sVCAM-1(sCD106), and VEGF concentrations. Higher baseline sICAM-1 and sVCAM-1 levels and lower sP-selectin and VEGF were observed in children with ALL. sICAM-1, sVCAM-1, and sE-selectin levels were decreasing following the treatment with protocol I. Higher sE-selectin and lower baseline sICAM-1 levels were observed in children treated unsuccessfully. Lower PAI-1 levels were observed in children who survived. Higher baseline sE-selectin levels and lower sICAM-1 and VEGF were observed in children treated unsuccessfully. A decrease in sE-selectin and lower PAI-1 at the 78th day of therapy were associated with better ECO. High baseline VEGF and sE-selectin levels, significant increase in PAI-1, and low initial sICAM-1 levels are prognostics for poorer prognosis in the ALL children.

Highlights

Activation of vascular endothelium under pathological conditions is associated with an increased risk of death in numerous severe diseases [1,2,3,4]
In our previous publication we showed that endothelial dysfunction belongs to pathologies observed in childhood acute lymphoblastic leukemia (ALL) prior to treatment and it may result from increased plasma concentration of ADMA
There were significant differences related to the complete peripheral blood cell counts in children with ALL when compared to the control group (Figure 2(a))

Summary

Introduction

Activation of vascular endothelium under pathological conditions is associated with an increased risk of death in numerous severe diseases [1,2,3,4]. Endothelial dysfunction (ED) is a common feature of many early complications of hemato-oncologic therapy which remain significant cause of morbidity and mortality despite the continuous optimization of treatment protocols [5]. At 78th day of treatment we observed both improvement in endothelial function and reduction of plasma ADMA concentration. It was accompanied by reduction of plasma prostacyclin concentration [7]. Recognizing endothelial dysfunction as a multifactorial disease, we intended to broaden in this paper the spectrum of analyses

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